Objective To summarize the clinical expedence in surgical treatment and prognosis of artrial septal defect(ASD)in adults and to know well the surgical indication of ASD in adults.Methods 32 patients over 20 years old with the left to right shunt and preoperative mean pulmonary artery pressure less than 8kPa underwent direct surgical repair for ASD under extra corporeal circulation.Results All patients survived after surgery,there was no surgical mortality in our group.32 patients were followed-up,29 of them with disappearing symptoms and 3 of them still had various symptoms.Conclusion The following condition ASD in adults who have slight to moderate clinical symptoms should be operated:cardiac enlargement eardiothoracic ratio over 50% and pneumonemia in X-ray films;right ventricular hypertrophy with a right axis deviation of incomplete right bundle branch block on the electrocardiogram;diameter of ASD over 1.5cm in ultrasonic cardiogram.

Objective To investigate the result of diagnosis and surgery of stageⅠnon-small cell lung cancer (NSCLC).Methods The survival of 47 stageⅠNSCLC patients performed surgery were retrospectively analyzed.Results There were 21 cases who were diagnosed by routine physical examination.The 1～,3～,5～year survival rates of the group of lobectomy were 93.8%,79.3% and 54.6% respectively.The1～,3～,5～year survival rates of wedge resection were 75.7%,42.6% and 35.7% respectively.There were statistical significances of the survival rates between the two groups(P

Objective To investigate the myocardial protective effects of“integrated strategy”with HOE-642 plus modified K/Mg on canine heart grafts.Methods Sixteen donors-recipient pairs of adult canines were divided into the“integrated strategy”group,i.e.,donor hearts were protected with HOE-642 plus K/Mg(IS,n=8)and the routine method(RM,n=8)group.Both groups un- derwent hypothermia stored for 4 h,followed by orthotopic transplantation.Cardiac heamodynamics was measured and myocardial ultrastructure and myocardial water content were evaluated.Results One of 8 animal died of aortic anastomoses leakage in each group,and the rest could wean from car- diopulmonary bypass successfully.Preservation of left ventricular contractility,as well as left ventric- ular compliance was significantly better in the IS group than in the RM group(P＜0.05),also,per- centage of myocardial water content was significantly lower in the IS group than in the RM group(P＜0.05).Myocardial ultrastructures were not damaged significantly in both groups,however,better myocardial preservation were seen in the IS group.Conclusion Both the clinically used“routine meth- od”and“integrated strategy”might provide safe donor heart preservation for 4 h,but the later scheme conferred more optimal effects with alleviating the myocardial swelling,preserving myocardial ultra- structure integrity and enhancing postischemic-reperfusion cardiac functional recovery.

As an important part of Chinese medicinal materials, uncommon-territorial herbs are also the most complex parts in the herbal medicine markets. Through years of investigation on the key markets of Chinese herbal medicine, the meaning of uncommon-territorial herbs, their historical evolution, origin and characteristics were clarified in this paper, and some countermeasures were put forward for its development.
Biological Evolution ; China ; Drugs, Chinese Herbal ; chemistry ; history ; Herbal Medicine ; history ; History, 20th Century ; History, 21st Century ; History, Ancient ; Medicine, Chinese Traditional ; history ; Plants, Medicinal ; chemistry ; growth & development

Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

OBJECTIVETo detect alterations of microsatellite loci [transforming growth factor beta receptor II (TGF-betaRII)(A)(10), TGF-betaRII(GT)(3), hMSH3(A)(8), hMSH6(C)(8), Bax(G)(8), IGFIIR(G)(8), IGFIIR(CT)(3)] and point mutations of TGF-betaRII (TGF-betaRII 452/454, TGF-betaRII 533).

METHODSPCR-SSLP, microdissection-PCR-SSLP, PCR-SSCP, clone sequencing and immunohistochemistry were used.

RESULTSThe mutation rate of TGF-betaRII(A)(10) in RER+ (replication error positive) colorectal carcinomas was 33% (3/9). Similar mutations were also observed in adenomas with severe dysplasia. No mutations at other microsatellite loci were found. RER+ colorectal cancers mainly occurred in male patients at a young age and were more common in the colon than in the rectum (P < 0.05).

CONCLUSIONSRER+ colorectal cancers were found in young males and commonly located in the colon. A one third mutation rate in TGF-betaRII(A)(10) in these patients is lower than that observed in western populations, which may imply diverse pathways of carcinogenesis of RER+ colorectal carcinoma. TGF-betaRII(A)(10) mutation may play a role in the transforming process from an adenoma with severe dysplasia to a full blown carcinoma.

Adult ; Aged ; Colorectal Neoplasms ; genetics ; Female ; Humans ; Male ; Microsatellite Repeats ; Middle Aged ; Point Mutation ; Polymerase Chain Reaction ; Protein-Serine-Threonine Kinases ; Receptors, Transforming Growth Factor beta ; genetics

OBJECTIVE: To evaluate the curative effects of AO clavicular hook plate in the treatment of dislocation of acromioclavicular joint and fracture of distal clavicle. METHODS: We retrospectively analyzed the clinical data of 39 patients with acromioclavicular joint dislocation or distal clavicle fractures treated with clavicular hook plate: 16 suffered from dislocation of acromioclaviculr joint, 18 suffered from far end collarbone fractures, and 5 patients had both symptoms. RESULTS: The 39 patients were followed up for 12 months averagely. All patients got good reduction and fixation. The acromioclavicular joint subluxation, breakage, and loosening of the clavicular hook plate were not observed. The acromioclavicular joint recovered quickly. CONCLUSION AO clavicular hook plate is a good choice for acromioclavicular joint dislocation and distal clavicular fracture.
Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Clavicle ; injuries ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Retrospective Studies

Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.

OBJECTIVETo evaluate some currently used surgical approaches to the correction of congenital penile curvature.

METHODSSeventy-six patients with congenital penile curvature underwent surgical correction, of whom 67 were accompanied with hypospadias, 5 with epispadias and 4 with normal urethral meatus. The methods for straightening the phallus included 5-week preoperative hCG treatment, complete degloving of penile skin, release of periurethral fibrous bands extending proximally to the meatus, plication of dorsal or ventral tunica albuginea, and embedding of dermis and tunica vaginalis grafts.

RESULTSAll the cases were followed up for 2 months to 2 years, and the mean follow-up time was 9.3 months. Satisfactory phallus straightening was achieved in 67 cases (88%), mild residual chordee remained in 6 (8%), which needed no reoperation for the time being unless warranted by follow-up, and relapse occurred in 3 (4%), which needed further operation.

CONCLUSIONMost cases of congenital penile curvature can be corrected sufficiently with the above methods.

Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Infant ; Male ; Penis ; abnormalities ; Urogenital Abnormalities ; surgery ; Urologic Surgical Procedures, Male ; methods

BACKGROUNDHepatitis C virus (HCV) core antigen assays have been produced to exclude infectious donations collected during the preseroconversion window phase (PWP). For the same purpose, we evaluated the specificity and sensitivity of a novel hepatitis C virus NS3 antigen detection immunoassay and the application of this assay in clinical diagnosis.

METHODSSamples from 77 healthy subjects, 173 anti-HCV positive patients and 3708 hepatitis patients other than HCV positive were tested with the HCV NS3 antigen assay. Some HCV NS3 antigen positive samples were further validated with HCV-RNA, neutralization and immunodot assays. Twenty-five sequential samples from 11 HCV NS3 antigen positive patients were subjected to kinetic study.

RESULTSOnly 48 (1.3%) of 3708 anti-HCV negative samples were positive for HCV NS3 antigen. Among them, 44 of 3030 samples from patients only infected with HBV were HCV NS3 antigen positive, 4 of the 445 samples from patients infected with other type hepatitis were HCV NS3 antigen positive. In addition, 42 (24.3%) of 173 anti-HCV positive samples were HCV NS3 antigen positive and all 77 samples from healthy subjects were negative to HCV NS3 antigen assay. Of the 15 HCV NS3 antigen positive samples, 9 (60%) were HCV-RNA positive. The neutralization and positive percentage of immunodot assay for 23 HCV NS3 antigen positive sera were 87.0% (20/23) and 69.6% (16/23) respectively. Of the 25 sequential samples from 11 HCV NS3 antigen positive patients, there was a negative correlation between the OD values and the duration of test (r = -0.989, P < 0.05), and there were correlations among their HCV NS3 antigen, HCV-RNA and anti-HCV titres. The anti-HCV antibodies of two sera were detected while their OD values of HCV NS3 antigen decreased gradually.

CONCLUSIONSThe HCV NS3 antigen detection assay showed perfect specificity and high sensitivity. Thus, it would be useful and economical as a routine test in laboratories for early diagnosis of HCV infection and prevention.

Alanine Transaminase ; blood ; Enzyme-Linked Immunosorbent Assay ; methods ; Humans ; RNA, Viral ; blood ; Sensitivity and Specificity ; Viral Nonstructural Proteins ; blood